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Non-surgical treatment of cervical cancer

Non-surgical treatment of cervical cancer

| from Booking Health GmbH | Diagnosis & treatment

Cervical cancer is a serious oncological condition, which annually takes the lives of thousands of young women. Cervical cancer is usually detected late and is difficult to treat starting from the 2nd stage. However, there are effective treatment methods to conquer it. Treatment for cervical cancer includes surgery, radiation therapy and...

Cervical cancer is a serious oncological condition, which annually takes the lives of thousands of young women. Cervical cancer is usually detected late and is difficult to treat starting from the 2nd stage. However, there are effective treatment methods to conquer it.

Treatment for cervical cancer includes surgery, radiation therapy and chemotherapy.

Is Cervical Cancer treatable?

Cervical cancer is treated at any stage of the oncological process. However, the goals of treatment can be different.

They are defined by:

  • Stage
  • Available means of therapy (financial capacity of the patient, technical and human resources of the medical institution)
  • Age of the patient, physical condition
  • Need to preserve fertility

The goals of therapy can be as follows:

  • Complete recovery. Cervical cancer may be cured no later than the 2 stage. Radical treatment provides a high recurrence-free survival.
  • Increased life expectancy. Combined treatment is used. There is a high probability of recurrence. However, the patient's life expectancy is increased by several years, which makes the medical effect justified.
  • Improving quality of life. If life expectancy can not be prolonged, palliative treatment methods are used to eliminate or reduce the main symptoms of the oncological process, usually those that are caused by the mechanical pressure of the tumor on the surrounding tissues.

How is Cervical Cancer treated?

Treatment of cervical cancer involves three main groups of methods:

  • Surgery
  • Irradiation
  • Chemotherapy

Сervical cancer treatment combines these methods. Treatment depends on how much the cancer has spread.

The stage is determined:

  • By the depth of the cancer invasion (how much of the tumor has grown and how much it has spread into the surrounding tissues)
  • By the presence of near and distant metastases

The location of the tumor and its histological type (squamous cell carcinoma or adenocarcinoma) also affects cervical cancer treatment methods.

Can cervical cancer be cured in the early stages?

Many women who have recovered from cervical cancer several years ago are still alive and healthy today. Radical treatment can eliminate the disease completely. If the tumor is removed before it gave metastases, there will be no recurrence.

However, everyone who completely recovered from cervical cancer:

  • Were treated at an early stage
  • Used radical methods of cervical cancer treatment

Radical methods include surgical removal of the tumor, and, more rarely (at stage 0), - destruction of pathologically altered tissues with minimally invasive procedures of physical impact.

 

Cervical cancer
(c) depositphotos

 

How to treat cervical cancer at different stages?

Different stages require different approaches for the cervical cancer treatment. The less the cancer spreads, the lower the risk of recurrence. Survival also depends on the radical nature of the surgery. A more preferred method of surgical treatment is hysterectomy - removal of the uterus. However, cervical cancer often develops during the reproductive years. Therefore, many women prefer organ-saving operations - conization.

This method enables the preservation of fertility (there is still an opportunity to have a baby), but the risk of cancer recurrence is higher.

Let`s discuss treatment of cervical cancer by stages. Different therapeutic approaches are used at different stages of oncological process. In some stages, surgery is required, in others it is not used or not mandatory to achieve the main goals of treatment.

Stage 0

The zero stage (preinvasive cancer) is diagnosed when the tumor does not spread beyond the mucous membrane. This is carcinoma in situ. Cervical cancer can stay in this stage for years before the infiltrative growth of the tumor begins. However, it is not manifested by any symptoms. The disease is rarely detected at stage 0.

Is it possible to cure cervical cancer without surgery at the initial stage of tumor development? Yes, radical surgical intervention may not be required. There are minimally invasive methods of treatment, which avoid using the scalpel.

The following cervical cancer treatment options are applied:

  • Cryodestruction - destruction of pathologically altered tissues with critically low temperatures. They cause necrosis (death) of tumor tissues
  • Laser Vaporization - destruction of malignant tissues with very high temperatures. Using high energy, the laser heats the cells  for a very short period of time, causing them to literally evaporate. In this case, the surrounding tissues are not injured. The area of influence is strictly regulated by the doctor

Often, women wonder by what age; treatment of preinvasive cervical cancer can be effective. There are no age restrictions. Radical treatment eliminates the tumor at any age. Another story is that if there is no need to preserve the reproductive function, it may be more preferable to undergo conization of the cervix, rather than cryodestruction or laser therapy.

However, it is not always possible to avoid the surgery, because preinvasive cervical cancer treatment which uses minimally invasive methods sometimes does not achieve a complete cure. As already mentioned, therapeutic tactics depend not only on the stage, but also on the location of the tumor and its histological type.

Sometimes more preferable and more effective cervical cancer treatment options are:

  • Looping conization of the cervix. It uses a loop heated by an electric current to high temperatures
  • Surgical conization of the cervix. A similar impact but by surgery, which differs from the previous one only by its method to achieve the same goal

During the intervention, a small cone-shaped area of the cervix is removed in the place where the tumor is located. The technique is able to preserve fertility, which is important for young patients.

After treating squamous cell carcinoma of the cervix, a woman is  monitored. She regularly undergoes diagnostic measures, because sometimes the tumor recurs. Often, women ask whether it is possible to cure cervical cancer without surgery after a relapse. No, minimally invasive techniques are not used again. If the tumor recurs, the optimal treatment method  is complete removal of the uterus.

At stage 0, chemotherapy for cervical cancer, as well as radiotherapy, is usually not applied. Surgical or minimally invasive radical treatment are usually enough.

Stage 1A1

In stage 1A1, the size of the tumor is very small. The depth of invasion does not exceed 3 mm, and the diameter of the tumor is less than 7 mm. There are no metastases yet.

For patients who wish to have a child in the future, the first method of cervical cancer treatment in the first stage is conization. The doctor always examines the wound for the presence of tumor cells. If they are not there, the woman is only being monitored, since it is not necessary to treat cervical cancer by other methods (chemotherapy, irradiation).

When detecting atypical cells after conization, radical trachelectomy is indicated. This surgery removes the cervix completely, plus the adjacent part of the vagina. This type of intervention is also indicated when the tumor infiltrates the arteries, veins or lymphatic vessels.

If the patient is not interested in preserving the reproductive function, a more preferable stage 1 cervical cancer treatment method is a simple hysterectomy (removal of the uterus).

In aggressive forms of cancer and also if the tumor spreads into blood vessels or lymphatic vessels, radical hysterectomy with the removal of pelvic lymph nodes may be required.

Stage 1A2

Stage 1A2 is different from the previous one because the cancer can reach 5 mm in depth. Since it is not always possible to cure cervical cancer through surgery at this stage, radiation therapy can be used additionally. Its use is desirable, but only if the woman does not want children.

In patients who do want to preserve fertility, cervical cancer is treated the same way as in the  previous stage.

There are two types of surgeries:

  • Conization
  • Trachelectomy with removal of pelvic lymph nodes

However, most women at the time of diagnosis are already 35-40 years or older. As a rule, they already have children and they do not plan new pregnancies.

Therefore, at this stage, cervical cancer treatment is more radical:

  • Radical hysterectomy with removal of pelvic and para-aortic lymph nodes
  • Remote irradiation
  • Brachytherapy (introduction of radioactive substances)

If metastases are found in the distant lymph nodes, the doctor can also prescribe chemotherapy.

Stage 1B1 and 2A1

In stage 1B1 or 2A1, the size of the tumor is quite large - it can easily be seen during the diagnosis. However, the diameter of the neoplasm does not exceed 4 cm. Metastases can be present in the nearest lymph nodes.

At these stages, fertility is still possible. To preserve it, doctors use a radical trachelectomy with the removal of pelvic lymph nodes. Radiation therapy for cervical cancer and chemotherapy in this case is not carried out, because they negatively affect the issue of fertility.

If preserving fertility is not an issue, the following cervical cancer treatment options are used:

  • Radical hysterectomy. The uterus and lymph nodes are removed and then examined for the purpose of detecting metastases. If they are not present, radiation therapy and chemotherapy may not be used.
  • Radiation therapy and chemotherapy. It is used after surgery if atypical cells were found in the lymph nodes with tumor spreading to the tissues surrounding the uterus, or in case of detection of tumor cells at the edges of the postoperative wound.
  • Brachytherapy. It is used after a remote radiation therapy and a course of chemotherapy to reduce the risk of tumor recurrence.

Women who are not sure whether it is possible to cure cervical cancer at this stage, sometimes refuse to have surgery. Some patients also have contraindications to surgical treatment. In this case, only remote irradiation and chemotherapy are carried out. It is impossible to cure cervical cancer this way. However, it is possible to slow down the tumor growth and prolong life expectancy.

Stage 1B2 and 2A2

Fertility can not be maintained. In stages 1B2 and 2A2, the tumor size exceeds 4 cm. Regional metastases may be present.

Stage 2 cervical cancer treatment of a large tumor size often begins with remote irradiation and chemotherapy. This allows doctors to reduce the tumor in size and make it more resectable. Thereafter a radical hysterectomy is performed. It includes excision of pelvic lymph nodes.

Stage 2B, 3 and 4A

Often, women are asked whether cervical cancer can be cured at stage 3. Most likely, it will not be possible to achieve a complete cure. The surgery is usually not carried out.

In stages 2B, 3 and 4A, the cancer spreads to the cervical tissues, vagina, pelvic wall, bladder, ureters. It can cause hydronephrosis. In most cases, metastases are present in the lymph nodes. Given how much the cervical cancer spread in stage 3, treatment is often performed without surgery. Only chemotherapy and radiation therapy are used to increase the patient's life expectancy.

Good clinics in economically developed countries use targeted therapy to treat cervical cancer of the 3rd degree. It is prescribed in addition to chemotherapy and improves survival rates.

Stage 4B

In stage 4, the tumor is large. It spreads into the rectum and beyond the pelvis. Distant metastases appear. Therefore, the question whether it is possible to cure cervical cancer at stage 4 is not even raised. Survival rates of patients is very low.

Surgical stage 4 cervical cancer treatment is not used. Doctors can only slow the growth of the tumor and alleviate the symptoms. In cervical cancer of the 4th stage, treatment involves remote irradiation and chemotherapy. Targeted therapy may be used as well.

Thus, whether cervical cancer can be cured is mainly determined by its stage and the woman's desire to maintain fertility. The most favorable prognosis is noted if the tumor has small dimensions, there is no need to maintain the reproductive function, and the surgery is carried out radically. Then the probability of curing cervical cancer is completely high.

 

Non-surgical treatment of cervical cancer
(c) depositphotos

 

Chemotherapy

Some women who are afraid of surgical treatment ask their doctor if it is possible to cure cervical cancer without surgery. Drugs are rarely used during the treatment.

However, the purpose of their application is:

  • Reduction of tumor size before surgery
  • Decrease of the tumor recurrence risk after surgical intervention
  • Increase in the duration of the disease-free period
  • Slowing the tumor growth
  • An increase in the duration and quality of life of the patient

Drugs or injection do not cure cervical cancer completely. For radical treatment only surgical methods are used.

At what stage of cervical cancer is chemotherapy used?

Usually at the beginning of the cervical cancer, doctors use surgical treatment. Chemotherapy is not required. In the second stage, it may not be used if the woman wishes to have a baby in the future.

If there is no need to preserve fertility, chemotherapy can be used for:

  • Stage 1 - if atypical cells in the lymph nodes or the wound are found after the surgery
  • Stage 2 - always, before or after treatment, to reduce the risk of recurrence
  • 3 and 4 stages - without surgery, which can no longer help a woman, in order to increase life expectancy

When does cervical cancer treatment start with chemotherapy?

Treatment begins with chemotherapy, and not with surgery, in three cases:

  1. A woman refuses to undergo surgical intervention or it is contraindicated for medical reasons.
  2. The tumor is large. In this case, chemotherapy and radiotherapy are conducted before the surgery to decrease the tumor. This will help the surgeon conduct the surgery more easily and improve the results of radical treatment.
  3. The tumor is unresectable. In this case, the treatment does not include the surgery. Treatment involves only chemotherapy and radiation therapy.

Now you are more aware of when it is possible to cure cervical cancer without surgery and only by drugs. You should not have any illusions about this. If your oncologist says that you need surgery, do not refuse to undergo the operation. Radical surgical treatment can significantly prolong one’s life and in many cases offer the possibility of complete recovery.

Radiation Therapy

In cervical cancer, radiotherapy is part of a comprehensive treatment. Its principle is based on the destruction of cancer cells with X-rays or radioactive particles.

The following types of treatment are used:

  • Brachytherapy
  • Remote radiation

In cervical cancer, the radiation is applied in such cases:

  • As part of a comprehensive treatment to increase the effectiveness of the surgery (increasing recurrence-free survival, slowing the growth of the tumor)
  • In combination with chemotherapy without surgery (after relapse or in large spreading of the oncological process, when radical treatment does not have significant effect on life expectancy)

The consequences of radiation therapy for cervical cancer

Naturally, radiation treatment for cervical cancer is not safe. It has both short-term and long-term consequences.

Possible side effects are:

  • Asthenia
  • Local skin damage in the areas of radiation (redness, peeling)
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain

The likelihood of side effects increases if chemotherapy was used simultaneously.

Possible short-term effects of radiation:

  • Anemia (a decrease in the level of hemoglobin and the number of erythrocytes in the blood)
  • Leucopenia (a decrease in the number of leukocytes and an increased risk of infection)
  • Violation of the cycle
  • Radiation cystitis (inflammation of the bladder, manifested by frequent urge to urinate and discomfort in the area)
  • Vaginal pain, increasing during sexual intercourse

Possible long-term effects of radiation therapy for cervical cancer:

  • Dryness of the vagina (eliminated with estrogen drugs)
  • Infertility
  • Early menopause
  • Stenosis of the vagina due to scarring and, as a consequence, pain during intercourse
  • Increased risk of bone fractures due to their demineralization - an average of 3 years after radiation (a result of early menopause)
  • Swelling of the legs due to radiation of pelvic lymph nodes

Smoking increases all the negative effects of radiation. Therefore, you should quit smoking it if you are undergoing treatment.

How long does radiation therapy last in cervical cancer treatment?

Remote radiation has the following scheme:

  • 5 sessions per week
  • The course of 6-7 weeks

Schemes can vary based on the types of radiation exposure used, its effectiveness, tolerability, and the clinical situation.

Brachytherapy in cervical cancer

Intracavitary brachytherapy is used for cervical cancer. Radioactive particles are introduced into the oncological location. They distribute radiation at the minimum distance. A source of radiation is placed into the vagina or cervix of the uterus.

Two types of brachytherapy are used to treat cervical cancer:

  • Low-dose - lasts for several days. All this time the patient is in the hospital
  • High dose - lasts a few minutes. It is performed on an outpatient basis. For each session, a woman comes to the clinic, but leaves home after the procedure is completed the same day

Diet in cervical cancer

You can often read on the Internet that nutrition in cervical cancer can improve the results of therapy. Some patients, after reading such stories, seriously ask their doctor whether it is possible to cure cervical cancer with a diet rather than surgery.

This is, of course, not true, because diet is perhaps important in treating tumors of the gastrointestinal tract. However, in oncogynecological diseases, you can eat anything. This will not affect the development rate of the disease, the risk of recurrence, life expectancy or other indicators of treatment effectiveness. One cannot expect that in case of cervical cancer the diet will help to avoid surgery and achieve similar therapeutic results.

Another story is that not all foods can be eaten during treatment, especially if a woman undergoes radiation and chemotherapy, or recovers after surgery. This will not affect the risk of recovery, but it will improve her well-being, facilitate the tolerability of the side effects of radiation and drugs.

Key recommendations:

  • Do not drink alcohol
  • You need to eat red meat to supply body with iron (women often develop hypochromic anemia)
  • If there is nausea, eat often, but in small portions
  • In case of diarrhea or vomiting, drink plenty of fluids to prevent dehydration
  • Eat plenty of fruits and vegetables - they are rich in antioxidants, which help to destroy free radicals.Free radicals are formed in excess during radiation

Is it possible to cure cervical cancer without surgery by using folk remedies or alternative medicine?

Sometimes patients use alternative medicine. In cervical cancer, treatment with folk remedies is not forbidden if the woman:

  • Uses it as an addition, not replacing the main treatment
  • It does not affect the health adversely
  • The herbs do not contain anticoagulants (do not "dilate" the blood), because in this case the risk of bleeding increases

Some patients ask their doctor, whether it is possible to cure cervical cancer without surgery, using home remedies or alternative medicine, wanting to achieve full recovery at the same time. We'll have to disappoint you. Currently, there are no such herbs, that would cure the disease, or at least improve the prognosis, slowing the growth of the tumor or reducing the risk of recurrence.

In cervical cancer, treatment with folk remedies can achieve such goals:

  • Psychotherapeutic effect in case of an unresectable tumor. The principle "you need to do something" is used, which improves the psychoemotional state of the patient, giving the patient a false optimism about the results of using herbs or food products for medicinal purposes.
  • Relieving symptoms. Many herbs have an antispasmodic or analgesic effect. However, in the advanced stages of cancer, when narcotic analgesics need to be used, symptomatic treatment of cervical cancer by folk methods is ineffective.

Now you know whether it is possible to cure cervical cancer without surgery. Gymnastics with ball, food, herbs, bee products - all these, perhaps, helps to reduce the symptoms for a while and improve the patient's psycho-emotional well being. However, it has no real effect on the course of the disease.

Moreover, treatment of cervical cancer with folk remedies can be harmful or have an adverse effect. If a woman believes too strongly in the healing power of non-traditional medicine and refuses to undergo surgery, it can lead to her demise. The disease progresses, and when at some point the patient does decide to resort to  a physician for help, it may turn out that the tumor is already unresectable, and radical treatment will become impossible.

Therefore, before treating cervical cancer with folk remedies, you need to ask yourself: have I exhausted all my medical remedies offered by scientific medicine? During the 4th stage, when doctors can do nothing more, folk remedies are fully justified. In other cases, it is preferable to use scientific medicine.

Organization of Treatment in Germany

Women often go to Germany to undergo a course of cervical cancer treatment at the best European clinics. However, many women do not receive quality treatment only because they do not know how to organize a trip, or the organization takes too much time and the disease progresses to the next stage.

It is better not to delay the beginning of treatment. Contact Booking Health. We will help organize your trip to Germany as soon as possible. We will undertake all organizational issues; we will help you to get a visa, organize medical documents, book a hotel, get you to the clinic.

With Booking Health we not only facilitate the process of treatment abroad, but also save you money.

You will get the opportunity to:

  • Choose the best program at an affordable price
  • Save on insurance for foreign patients, which reaches 50% or more of the total cost of the program
  • Avoid the need to pay remuneration to intermediaries

With Booking Health you save up to 70% of the money that would be spent on a self-organized trip to Germany.

 

Treatment of cervical cancer in Germany
(c) depositphotos

 

Choose treatment abroad and you will for sure get the best results!

 


Author: Dr. Nadezhda Ivanisova

 

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